Page 222 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials
P. 222
Chapter 10
mesh and the muscles. In particular, the layer between material and muscles appeared to be very organized based on the homogeneity of color. The collagen bers of the Permacol mesh itself showed a structured orientation of collagen bers. The mesh and the muscle layer had almost no collagen between them, as indicated with a “c” in Figure 6. Furthermore, this layer was very organized in one direction. A small layer of collagen with bers in several di erent orientations separated Strattice mesh from the abdominal muscles. Surgisis mesh was completely incorporated into connective tissue, with collagen bers crossing the surrounding tissue and the Surgisis mesh (indicated by * in Figure 6).
Figure 5. Histologic sample of Permacol mesh at the 30-day follow-up assessment. The liver is strongly attached to the mesh. 1 Permacol mesh. 2 Fibrotic layer. 3 Liver.
Discussion
The current study analyzed ve di erent meshes in terms of adhesion formation, incorporation, and shrinkage after 30 and 90 days. For these three parameters, Parietex composite mesh demonstrated the best long-term results compared with all the other meshes. The biologic non-cross-linked mesh, Strattice, showed little adhesion formation and moderate shrinkage but poor incorporation.
# "
!
220
